Unilateral Ad Hoc

2009/01/04 08:18 PM

The first thing that people talk about when you have overabundant milk, is block feeding, or foremilk/hindmilk imbalance, and it feels like it's some countable, quantifiable *thing* that's broken that can be fixed with just the right number of hours of nursing, or not drinking the "bad" early milk or all kinds of things that confuse and "box" the mother into what's wrong with her or what prescription will fix her problem instantly, and if it doesn't she's not doing it "right". So what do I do about needing to nurse many times in a day, but staying more times on one side? Do I "block" it up into 3, 4, 5 hour chunks? When do I switch sides? How do I know what to do when?

I prefer the more, no pun intended, fluid term for what is needed to cope with switching sides - unilateral ad hoc. It sounds like a technical term, but it really just means "one sided, as needed". It puts the control back in the mothers hands. Yes, it means that I have to figure it out. But it also gives me permission to say I'm the best person to figure out what's right. But where do I start?

In a breast with "average" milk flow, over the course of one feed the baby gets a small amount of early milk that immediately available , and then the milk speeds up with the letdown in a few 10's of seconds and quenches the baby's thirst, then that subsides and slower, higher fat milk is drawn down from the breast to fill the baby up and "fatten" them up. In a breast with higher flow there is so much early milk, and so much milk is ejected at that letdown that the baby never gets to that later higher fat milk.

Nursing on the same side again allows the baby to "finish" that later milk (though sometimes with a bit of another letdown of milk as well, though that often decreases as the days go on and things improve, and the second letdown on the same side is usually calmer anyway).

But milk flow slows down in the evening, so it might take less time to use the first breast. And my milk is often hugely full in the morning so I would like to stay on that first side for a long time, but then the side that didn't get used much overnight AND all morning feels like exploding. So I have to play with it. Right now I nurse one side in the morning to get it a bit more comfortable and then I switch sides and nurse on that side for a few times, maybe for the rest of the morning-ish (I never look at a clock, just listen to the fullness of the other side and what it's telling me). And then I switch to the "afternoon" breast and try to stay on it til the non-nursing breast is starting to feel just on the edge of uncomfortably full again (yes you want it to be a bit uncomfortable, that fullness is what tells the non-nursing breast to slow the flow, cause the milk is just not needed as fast as it's making it).

Then in the evening I stay maybe a second nurse on the same side, but often she wants to nurse enough that sometimes I even switch back to get her to cluster nurse more in the evening. Sometimes I don't because it just didn't feel like it was going well and she needs some slower milk still, and sometimes it really seems like she needs a bit more milk to get to sleep, and if I get too full on the one side, I'll wake up in the morning ready to explode again, and when we have bad morning nurses that's the day she grumpiest in the evening cause of all the gas from that bad morning nurse.

So it's a constant play by play. And teasing out the right thing to do. And she's still so young and we'll see what we have to do with her, but I know that if I start to think about it now that I'll be better at finding her pattern sooner.